Provider Demographics
NPI:1790099380
Name:TOVAR QUIROGA, DIEGO FELIPE (MD)
Entity Type:Individual
Prefix:
First Name:DIEGO
Middle Name:FELIPE
Last Name:TOVAR QUIROGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 PARK BEND DR
Mailing Address - Street 2:BLDG 2-203
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5592
Mailing Address - Country:US
Mailing Address - Phone:512-339-8831
Mailing Address - Fax:512-339-8841
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:SUITE 2-203
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:507-284-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ90612084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology